Provider Demographics
NPI:1881972123
Name:BIVIN, REEM ANN (NP)
Entity type:Individual
Prefix:MRS
First Name:REEM
Middle Name:ANN
Last Name:BIVIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1607 COLIMA RD
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19115-4205
Mailing Address - Country:US
Mailing Address - Phone:267-372-3758
Mailing Address - Fax:
Practice Address - Street 1:1480 OXFORD VALLEY RD
Practice Address - Street 2:
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-5630
Practice Address - Country:US
Practice Address - Phone:215-321-3921
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-03
Last Update Date:2011-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP011415363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily